A new project from Luna Tierra Birth Center in El Paso brings families together for a communal approach to childcare.
The casa de partos, staffed by bilingual midwives, offers an intimate environment for childbirth, with birthing rooms that look like bedrooms and a large, modern bathtub for water births.
El Nido, a project from the birth center, provides a space for expectant mothers and parents to learn about different topics during and after pregnancy – such as how to use different types of baby carriers and how to prepare mentally and physically for childbirth. El Nido held its first event, a postpartum cooking class, in September. Every month El Nido hosts a free lactation circle for breastfeeding mothers to get tips and socialize.
The organization aims to keep events free or low cost, with recent instructor-led classes ranging from $10-25
Leticia “Lety” Knight, a midwife at Luna Tierra, said El Nido grew from her team’s desire to expand beyond birthwork, as well as conversations with clients who asked whether Luna Tierra offered classes or support groups.
Knight, who’s helped breastfeeding mothers at El Jardín Birth & Family Resource Center, has seen how isolated a mother can feel in the postpartum period. The coronavirus pandemic shuttered in-person support groups starting in 2020 – including El Jardín, which went virtual for a temporary period – but the time felt right to reintroduce these groups at Luna Tierra, Knight said.
The women-led center has three licensed midwives who work alongside student midwives. The center also works with doulas in El Paso and Ciudad Juárez. Luna Tierra stands as one of just a few birth centers in the El Paso area, alongside Maternidad La Luz.
Doulas provide emotional support during and after pregnancy, while midwives can also provide medical care such as performing cervical checks, ordering lab tests and catching newborns during delivery. To become a licensed midwife, they must complete training, such as the Texas Association of Midwives program, which requires at least two years of clinical training in addition to coursework. Some nursing schools also offer a midwife track for students to become a certified nurse midwife.
Luna Tierra oversees about 100 to 150 births every year and about half the clients prefer speaking in Spanish, Knight said. Some clients travel from Juárez. She stressed the importance of Luna Tierra reflecting her community – binational and bilingual, as well as Chicana, immigrant and Indigenous.
Knight’s grandmother was a Rarámuri partera, or midwife, but her family didn’t talk openly about the details of childbirth. Sex, birth, pregnancy loss and reproductive history seemed like taboo topics, she said. Her goal is to change that culture so families can feel open talking about reproductive health.
Another midwife at Luna Tierra, Stephanie Torres Murillo, described El Nido as a “community space where moms can come and build a network for themselves, build a village.”
Some people who gave birth during the first years of the pandemic may not have had a village – they had to experience the difficulties of pregnancy and postpartum life in isolation while people around them were dying from COVID-19, Murillo said.
It’s important for these mothers who missed out on support earlier in the pandemic to now have a community to turn to, she said.
“It’s kind of like, ‘Hey, it’s been hard,’” Murillo said. “‘Let’s just get together and sit down and be a community. Let’s eat food together, let’s have a chocolate drink together, let’s talk about our difficulties.’”
Holistic pregnancy care
Luna Tierra Birth Center opened its doors in 2017 on the corner of Gateway South Boulevard and Hueco Avenue, offering services to people with low-risk pregnancies.
Upon entering Luna Tierra Birth Center, to the left are the birthing rooms, as well as the community gathering room for El Nido. To the right are the clinical rooms where clients attend their prenatal appointments.
Midwives take their belly measurements and vital signs, check fetal position and listen for fetal heartbeat, and assess for possible complications. If the complications fall outside the scope of Luna Tierra’s practice, their midwife will refer the client to an obstetrician, a physician that treats medical conditions during pregnancy and can perform surgeries related to labor and delivery.
Knight thinks of when her mother was pregnant; she was an undocumented woman living outside of Chicago who needed translation help. Health clinicians don’t always personalize their care to their patient’s background, such taking into consideration language, customs, mental wellbeing and access to resources, Knight said.
“Anytime I have interactions with clients or families, it’s like, ‘Okay, how would I explain this to my mom? How would I have wanted them (health care professionals) to connect to my mom?” Knight said.
The workers at Luna Tierra Birth Center advocate for bodily autonomy, such as giving people the freedom to walk and move around during labor. People can select music as well as aromatherapy options.
According to the midwifery philosophy, pregnancy and birth are a physical, psychological and social process, not just a medical event.
In an obstetrical setting, some people feel like they don’t have choices – for example, their doctor may pressure them into scheduling an unnecessary cesarean delivery rather than wait for a vaginal birth, Knight said.
People also don’t have to lie down on their back to give birth, she added. Some people prefer lying on their side. Most clients at Luna Tierra give birth in an upright position, such as squatting on the birthing stool, and let gravity help them push. A sling hanging from the ceiling also allows people to grip on to something while pushing.
More than 98% of births in the United States took place in a hospital in 2017. Midwives attended less than 7% of births in Texas, according to a report on birth preferences from the University of Texas at El Paso.
Murillo said she wants people to have more choice over their bodies regardless of where they seek health care – whether to have a C-section or vaginal birth, to receive epidural anesthesia or have an unmedicated birth, to keep their pregnancy or terminate it.
“I think as a midwife who had all her children in a hospital, with epidurals and inductions and all these things, when a client comes in and decides they want to go to the hospital, I’m able to say, ‘Hey, I had hospital births and there was nothing wrong with it.’” Murillo said.
“My true goal is to let people know they have bodily autonomy,” Murillo said.
Building a village
In some cases, pregnant people have an entire team guiding them: an obstetrician, a midwife and a doula. Knight hopes more physicians and hospitals in El Paso will be open to working together.
Knight is currently supporting a Venezuelan mother at the birth center, who was pregnant when she crossed the border to apply for asylum. Knight’s volunteer work with pregnant migrants at Sacred Heart Catholic Church made her realize there needs to be more pathways in El Paso for people interested in becoming doulas, she said. Many pregnant migrants she’s met hear their baby’s heartbeat for the first time when they’re in El Paso. Some have lost their pregnancies without realizing it after such a physically excruciating journey.
Doulas could provide emotional support to people who have gone through traumatic pregnancy and pregnancy loss, while connecting them to health care services, she said. El Nido, then, could at least open the door for people in El Paso who are interested in learning more about birth work.
Cassandra Sainz taught a workshop in November on baby wearing, the practice of carrying a baby in a sling or carrier attached to the body. There’s a variety of baby carriers, so it can feel overwhelming figuring out which baby carrier works for them, she said. The workshop allows people to try different types of carriers before spending money on one.
“When I tried the first time I was really lost,” Sainz said. “It was kind of intimidating to use a carrier by yourself especially when you have a newborn that’s crying, you’re hungry or you’re tired.”
Sainz said her daughter didn’t like the crib, swing or bouncer, so baby wearing was a way to keep both her daughter relaxed and her hands free to do tasks. She hopes these workshops will help other mothers in similar situations.
Isabela Williams, a Brazilian immigrant who gave birth in July, said meeting people at the baby wearing workshop and lactation circle made her feel less alone.
As a former dance teacher, Williams hopes in the future to teach a dance class for parents and their children at El Nido.
“When you’re pregnant, you really feel unstable,” Williams said. “I’m here by myself. I don’t have my family here. They gave me the space to talk about it. I said I know it was minor things, but they said you have to honor your feelings.”